HomePsychology Psychology; A Clinical Assessment of Annie Wilkes from the movie " Misery"

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Psychology; A Clinical Assessment of Annie Wilkes from the movie " Misery"

Azad Moradian

vokradio.com;The purpose of the following article is to help graduate and undergraduate level students in the fields of psychology, social sciences, and/or film be able to have a model of how to look at a movie from the perspective of their fields of study and write a paper utilizing their knowledge.
In the following papers movies are analyzed, interpreted, discussed, and ultimately criticized a way that is very specifically related to academic understanding of psychological subjects, which is a different way of looking at film than the traditional way. We hope that you can find the following helpful and we will appreciate your comments as well as any submissions that you might have that could be published in this category

In the movie Misery a famous romance novelist Paul Sheldon is rescued
from a car wreck by Annie Wilkes and nursed back to health in her
comfortable cabin. Annie Wilkes introduces herself as a certified nurse
and his "number one fan" and tells Paul that he has nothing to worry
about. In the beginning, Annie is presented as a capable, caring, and
devoted fan who is willing to help Paul get back on his feet and go
back to his normal life but very soon it becomes apparent that her
motives are not sensible. Annie displays a series of obsessive,
delusional and dangerous behaviors through the course of several weeks
that reveal her unstable troubled mind. Paul becomes trapped in a game
of life and death in the mercy of a woman who is clearly a psychopath

:Character overview

Annie Wilkes is a 48-50 years old Caucasian woman. She lives alone in Silver Creek, Colorado in a cabin and owns farming land and animals. She is single and does not have family, friends, or close acquaintances. She is heavy built, strong, physically healthy, and an independent woman. She works on her farm and takes care of a few farm animals including her pig pet “Misery”. Her house is well organized, clean, and detail oriented. As needed she drives her car to the local shop in town and purchases basic items. She cooks her meals and enjoys late night dating shows on her television set. She does not have a telephone line but has telephones around the house. She dresses in conservative attire and always wears a Cross necklace around her neck. She is very religious and mentions God many times during her conversations. She speaks in a proper English and does not use foul language. The joy of her life comes from reading romance novels written by Paul Sheldon. She has the collection of Paul Sheldon’s books and has read these books several times each. She has most of the stories memorized by heart and associates closely with the heroine of the novels Misery Chastaine.

Background history:

There are very limited information regarding the character’s background and developmental history. Most of the information has been attained from newspaper articles and other documentations found in her house, or through her conversations. The newspaper articles were found in her “scrap book” in which she creatively organized major events of her life.
It appears that Annie Wilkes is the only daughter of Carl and Nancy Wilkes and lived her childhood in Bakersfield California. The character mentions that her favorite activity while growing up in Bakersfield was to go to the movies and watch “chapter plays”. She also says that she was not very popular with other children because of her temper. An article in a local Bakersfield newspaper, found in the patient’s “scrap book”, reveals that on Sunday June 29th, 1963 Carl Wilkes, a local Investment Banker had been found dead by his 11 year old daughter Annie Wilkes after falling off from the stairs of their home. The article announces the incident as a “freak accident”. The relationship between the patient and her parents is unknown; therefore, an accurate speculation regarding the significance of Carl Wilkes death on then 11-year-old Annie Wilkes cannot be made. Assumptions can be made, however, on the traumatic affect of a parent’s death on a child. There is no evidence that the death of Carl Wilkes was in fact an accident. A card is pasted next to the article with the words “With Love to Dad on Father’s day”. Annie does not mention her parents in any conversations with Paul.
Annie Wilkes attended the University of California Los Angeles Nursing School and earned her RN with honors. Articles in the patient’s “scrap book” reveal that an honor-nursing student at UCLA had died from injuries to the head after falling off of the stairs and that Annie Wilkes had been a witness of the accident. The relationship, role, or significance of this classmate is unknown. Following that article are other obituaries revealing “accidental” or “mysterious” deaths of several people in the intensive care unit where Annie Wilkes had been in charge as a head nurse. She took the post of head maternity nurse at Elridge County Memorial Hospital in Denver, and a series of mysterious deaths began to take siege of the hospital’s maternity unit. Several articles dated in 1984 reveal that 5 babies had been found dead within a month and Annie Wilkes was taken to court and questioned as a suspect; however, they did not find her guilty of the murders.
Annie Wilkes does reveal that she had been married and when her husband left her she was unprepared and took on more work, including night shifts at the hospital. There is no mention of Annie having any children of her own.

Diagnosis:

Axis I: 295.70 Schizoaffective Disorder, Bipolar Type
Annie Wilkes meets all of the Diagnostic Criteria for Schizoaffective disorder. She falls into the subtype Bipolar type due to the fact that she displays mixed episodes of depressed moods and hypo manic states along with delusions.
Symptoms begin to reveal themselves very early in the story. After reading several pages of Paul Sheldon’s unpublished book, Annie is offended beyond remorse by the profanity of the literature. The next day she tells Paul that “I asked God about you and God said I delivered him on to you so you might show him the way” and then she forces Paul to “rid the world of the filth” by burning his book. When Paul refuses, she goes as far as pouring gasoline on his bed and gesturing burning him if he does not obey. Annie mentions that God came to her and told her that Paul’s purpose for being there was so that she could help him write another “Misery” novel. Annie tells Paul that she has known for some time why she was “chosen” to save him and that they are meant to be together forever and in order for that to happen they have to die together. She says, “Now the time has come. I put two bullets in my gun. One for me, and one for you. Oh darling, it will be so beautiful.”
Annie suffers from shifting moods. She goes from being suicidal on a rainy night to making pig noises in an energetic, hyper mood and playing with her pet on another day.
Axis II: 301.22 Schizotypal Personality Disorder

Annie Wilkes meets most of the criteria for the Schizotypal Personality Disorder. She lives alone in a remote area outside of town, and does not have any close friends or acquaintances, which reflects “pervasive pattern of social and interpersonal deficits”, seen in this personality disorder. She enjoys the company of a pig rather than people. She has eccentric behaviors and mannerism that seem odd and at times bizarre. She jumps up and down when she gets excited even though she is close to 50 years old. She uses words such as “dirty-birdy” and “cocka-doodie” and her language is over elaborated when she wants to express strong emotions. Her facial expressions are . excessive and animated

Annie Wilkes has many features of borderline personality disorder as well; however, does not meet the DSM criteria or the key feature of this personality disorder, which is a pattern of unstable and intense interpersonal relationship and intolerance for being alone. Some of these borderline” features are: She has no impulse control. She becomes angry and irritable very easily and goes from sitting quietly to jumping from her seat and screaming at the top of her lungs. After reading a few pages of Paul’s unpublished book she is sitting by his side, feeding him soup and expressing her concern with the profanity and in mere few seconds she becomes so angry that she spills the soup on the bed. Her feelings for Paul Sheldon shifts from adulation to loathing. When she realizes that at the end of the eighth book Misery dies she barges into Paul’s room in the middle of the night hysterically and yells “YOU! YOU DIRTY BIRD, HOW COULD YOU! She can't be dead, MISERY CHASTAIN CANNOT BE DEAD! I DON'T WANT HER SPIRIT! I WANT HER, AND YOU MURDERED HER! I thought you were good Paul but you’re not good! You’re just another lying dirty birdy!” Only a day before this event she had said that the Sistine Chapel and Misery’s child (Paul’s book) were the only two divine things on earth.
Another major feature that is worth mentioning is that Annie feels no empathy and does not seem to regret her destructive behaviors. In this sense she displays features of Anti-social personality disorder.

:Major Defense Mechanism

Denial: Annie continues to believe that Paul will eventually like being with her even though it is obvious that he despises her.
Fantasy: Annie is consumed in the Misery novels and lives vicariously through Misery.
Projection: Annie has killed many people in her life; however, when Misery dies in the novel she accuses Paul of being a murder.
Rationalization: Annie rationalizes her actions and behaviors by saying that God told her to do what she is doing and that it is her duty.
Reaction formation: Annie has become very religious, she says people should help other people and wants to “rid the world of filth” even though she has killed and hurt people all of her life. She has chosen the nursing profession where she has to nurse people despite the fact that she hurts and kills them.
Emotional Insulation: Annie’s disconnect with people and living alone could be an example of trying to reduce ego involvement.
Regression: Annie behaves very immaturely and childlike when she is excited or not in charge.
Identification: Annie associates herself with the Misery novels and feels important by being Paul Sheldon’s “biggest fan”.
Acting out: Annie said she was unhappy and lonely working long hours at the hospital, at the same time she began killing babies which could be an example of acting out.
Splitting: Annie sees Paul as all good one minute and all bad in another minute. She feels overwhelmingly happy and feels that life is full of joy and romance when her needs are met but suicidal and depressed when she feels vulnerable.
Fixation: Annie is obsessed with Paul and the Misery novels.
Axis III: None
There is no reference or indication of a general medical condition. Annie Wilkes seems like a very healthy and strong individual despite being somewhat over weight.
Axis IV:
Problems with primary support group: Annie’s father died when she was 11 and her mother’s ware about is unknown. She has no siblings or family members. Husband abandoned her several years ago and she has no children.
Problems related to the social environment: No support system is available. Living alone. Annie was fired from the hospital and can no longer work as a nurse. She has been nicknamed “The Dragon Lady” by the media following the baby deaths.
Problems related to interaction with the legal system/crime: Annie had been a suspect in the deaths of newborn babies several years ago. She was found not guilty.
Axis V: Global Assessment of functioning (GAF) for Annie Wilkes is 10
Although Annie seems functional she is a “persistent danger of severely hurting self and others…” and thus her GAF falls in the rage of below 10.

:Possible Etiology

Schizoaffective disorder is most probably caused by biological and genetic factors.
The personality disorder can be rooted from traumatic childhood experiences, family instability, and maladaptive role models. In Annie’s case, very little is known about her upbringing and family dynamic therefore it can not be determined what could have set the stage for her behaviors.

:Treatment Modalities

Annie needs to be incarcerated immediately and under 24 hour supervision in order to prevent her from killing herself or someone else. Under a psychiatrist’s care she need to be put on antipsychotic medication and perhaps mood stabilizers. Her medications need to be closely monitored in order to stabilize her and prevent her from not taking them. The best therapeutic approach for Annie would be a cognitive-behavioral approach to help her manage her anger, and control her impulses. Since Annie is intellectually capable, a psychodynamic therapy can also be useful in understanding why she engages in hurting others and helping her face reality by giving up her maladaptive habitual defense mechanisms.
Prognosis: Very Poor

Due to the severity of her symptoms the only hope would be to maintain her from being a danger to herself and others. Treatment should mostly be focused on stabilization her.